Background Rarely are Two-Spirit and/or Aboriginal (i.e., First Nations, Métis, and Inuit) gay, bi, or men who have sex with men (gbMSM) included in research projects that center their experiences and ways. This study examines the main drivers of sexual health knowledge (SHK) among Aboriginal (N=365) and Two-Spirit respondents of Sex Now 2014-15 (SN15), a national periodic survey conducted by the Community Based Research Centre for Gay Men’s Health in Vancouver.

Methods Associations were examined between SHK, using a combined score of 6 survey questions, and the following explanatory variables: Two-Spirit identity, living in urban settings, income, education and gay peer networks (GPN). Correlations between explanatory variables were examined using unadjusted odds ratios, and univariate and multivariable linear regression estimated associations between each of the explanatory variables and the SHK outcome.

Results Using the Lakota expression, Mitakuye Oyasin, “all my relations,” the drivers studied were interrelated: those living in urban environments had larger GPN; higher educational attainment had more income; and larger social support network had higher levels of educational attainment and larger GPN. Three main factors were positively associated as drivers of SHK: income, education, and size of GPN. Two-Spirit respondents had higher SHK than other Native men in urban settings but not in non-urban settings.

Conclusion To increase SHK with those with lower levels of education or income, or who are not connected to the “gay” community requires new ways of conducting outreach and engagement. Urban Two-Spirit folks are likely connected to one another and may get better information related to HIV prevention technologies, which may differ from those living in rural settings. Further research is needed with a larger sample and additional survey questions specific to experiences of Aboriginal gbMSM.

Disclosure No significant relationships.